¶ Teran Gates and Her Prosthetic Clinic
Hey everybody . We're back again with another episode of Big Talk About Small Business . My partner is not chiming out . I wanted you to own it , this episode Come on .
Okay , big big talk about small business . Talk about business Sorry .
I put you on the spot . You really made that uncomfortable , I know . In any case , it's Eric Howerton and myself , and also my friend Teran Gates is here with us in the studio . How are you doing this morning , teran ?
Pretty good , it's been a good morning .
Has it .
We're having a piece of pie over at the pie house . Oh nice , that's a good way to start .
I like that . I started out at McDonald's yeah , you did , and I went inside . You went to the gym and it's always interesting when you sit inside McDonald's the cast of characters that's in there . There's usually some old people and they're taking care of each other and that's kind of cute .
And then there's the homeless people who are taking showers and the bathrooms sink . I had some of that today too . That's a good way to start the morning , bro , I know this makes me sound terrible and I know there are a lot of people out there suffering , but this homeless couple looked absolutely normal . They were in their late 20s .
Each one had a cell phone . I studied them . They had a new iPad in the box that they were setting up while they sat at the table , and the best accessory they had was a fake baby wrapped up in a baby blanket , which they then shoved into a giant black trash bag along with the rest of their stuff . But I think that was probably a sympathy getting tool .
I mean , you know , you've seen it . It's a fact that here the homeless people , at least in Fayetteville , are actually working shifts and they're organized and there are people that are out there pimping them out .
Back on this conversation .
Collecting the money . There was a whole conversation that was overheard recently at a restaurant where one person was being trained about how to be , you know , the beg for money .
And policy and procedure meeting .
Yeah , it's true . It's like we gather y'all up Now four o'clock , we have a shift change , we got a coffee break from one to one-fifteen . Anyway , it's like working , it's working , it is . But anyway , that's not what we're here to talk about . I'm sorry to sidetrack us . Okay , we're here to talk about Teran in Teran's new business .
Tell us a little bit about yourself , teran . Teran has a business called the Gates Clinic .
Yeah , that's the abbreviated , because the long version is a little wordy .
Give us the long version .
So it's Gates Prosthetic and Mobility Clinic .
Gates Prosthetic and Mobility Clinic and I know she's got a lot of experience in dealing with prosthetics and prosthetic patients . Tell us a little bit about yourself . Where'd you grow up ?
Sure , so I grew up in Batesville , arkansas .
Okay .
It's a pretty small town , very much small town culture , and from there I went to U of A and got my undergraduate degree that was in kinesiology and a math minor , and then I went on to a master's program at UT Southwestern in Dallas for prosthetics and orthotics .
What got you to prosthetics ?
Well , so I thought I wanted to do physical therapy , and I worked in a clinic through the summer in high school and they had a patient there that was an amputee , and so I started looking into that and shadowing in those clinics and really just fell in love with the balance of working for people and working with your hands .
And everything is evolving and changing all the time , so it stays very unrepetitive . It's always adapting and you're always having to learn new things and keep up with the new technology .
I always tell people that , like I've said this to several of my kids and I've listened but it's like I don't know what I want to do when I grow up and I'm like looking to physical therapy . It seems so gratifying to me . I've been through it multiple times for one thing or another .
I got a bad knee from kickstart and old Norton motorcycles and stuff like that and I had destroyed my left hand here in a motorcycle accident . But it's always fun when you go there . It's always sort of a community as a patient . All the therapists they're nice . You become friends with them and then sometimes you'll be on the same cycle with other patients .
There's like a little community . Everybody's talking and it seems like it's such a would be so rewarding because it is so helpful .
Yeah , yeah , you know , definitely is . You don't know how helpful it is until you've been through it , because I had no idea what they were about . But then , yeah , they got me through some shoulder pains that were pretty rowdy and some hip pains too .
I had a shoulder thing where my arm just was like numb and you know where you get that weird yelling at it , but I turned out to be a pinched neck nerve . Yeah , then you know , they put you in neck traction and all . But it is a very rewarding field and you help a lot of people . So I can see why somebody would like that .
Now I don't know about the math major . How did that work in with that ?
Well so I started in engineering so I went through all of the math courses and it was like , well , I can take one more and have a minor , so I might as well . I said well , it's and it was ironically a GPA boost , because those were all my A's and college .
Dumb girl . I mean just yeah , like just a real slacker .
You'll find how much I've inherited .
Yes , so anyway , so you got your master's degree . Then you were , you worked while you were in school , you said , at a PT clinic .
Yes , that was in high school .
Okay . In Batesville yes , okay . And then what happened ?
So I'm from there . I did my residency in our field . It's a master's degree and then at least two years of residency . Okay , and then you take board exams . So I went back to Arkansas and practiced in Mountain Home and finished my residency , took my board exams and , as we say , became a real person in the field .
Is that it Mountain Home ? Wow , that's where I used to go when I was a kid .
I loved it . Yeah , it's a beautiful thing , malware . It's gorgeous up there it is .
There were two bars in town , that's all I remember . The Red Fox was at the Holiday Inn and then there was something else on the other end of town and anyway , we used to go there as kids Most people go there for like the lakes and rivers , yeah the Lake Norfolk , but you were there for the bars . My friend's brother-in-law had a cabin on Lake Norfolk .
That's why we went there , but it gets really boring after a couple nights of playing cards and drinking beer . So we didn't have to move to the whore , but anyway , back so then . So you went through the two-year residency and then how did you end up here ?
So I've had some family move and so I ended up splitting my time and covering both clinics and Mount Home and Rogers and that was fairly unsustainable . I did that for a year to a year and a half with kids and a family . So you were commuting and get up at five , drive two hours see a full day of patience .
We had two houses so we were splitting our time so you never know where any of your stuff is and you get home at nine o'clock , you eat some Mark-A-Wave food and you go to bed and you did again . So we did that for , like I said , a year and a half . I eventually said I'm not doing this anymore .
So I came over a year full-time and in healthcare and what we do it's really lifelong relationships with your patients and so part of that was really hard on me because there were people that I'd seen for four years at this point , and I remember actually crying on my last day there because it was saying goodbye to these people and not knowing whether I'd see
them again and hoping that the hands that I was leaving them in were going to keep them as active and healthy and mobile as I was trying to do .
Yeah , I'm sure .
So I came over here and built the same thing here , and I feel that way about everywhere I've been and gone and the patients that I've seen .
So now I have my patient family here , and I've been practicing in this area for about four years now and I have to stop and think about how long I've been here and really how many relationships I've developed in the area too .
Did you have your own clinic in Mountain Home ?
No , so that was when I was working with a family-owned business there . So that was a large reason why I took that residency and joined that practice was that it was a family-owned business . I had a really good interview with the CEO at the time and really liked just the freedom of innovation that they offered .
It wasn't about how much can you turn out and how fast can you do it . It was about caring . Caring .
And then when you moved here , is that when you opened up your own clinic .
No , so that was again with the same company . Okay , oh okay , so we actually expanded them and opened a clinic in this area and in part , to create an opportunity for me to move to the issue that my family was in . So that was part of the reason . Part of the market .
Obviously it was growing and there wasn't enough suppliers in the area , so we saw a good opportunity come .
So what exactly do you do for your patients ? I mean , do you provide them with the prosthetic ?
Sure , yeah it's a little confusing about how all that works .
And then I assume you give them a lot of therapy to be able to use it effectively , right ?
So what we do is we fit and customize the prosthesis to the individual . So the components , as far as like the knee and the feet and those kind of things , are made and manufactured by facilities . They're tested , they go through cyclic testing . We don't make those parts , but everything that goes .
Do you design them ? You give them specs on what you want .
No , it's more about matching the person to what's out there .
I see .
Not everybody gets a forward right . That may not work for everybody Somebody who's a Corvette but it's about assessing their weaknesses , their strengths , their goals , their surroundings and environment and what matches . And then the more important part is the patient interfacing part .
So it's more like custom modifications to that part is completely custom from scratch .
Something that I'm doing that's a little differently is I'm keeping that part in-house and making it myself . A lot of that is being sent out and central fabricated and it's a little more mass produced .
So you're making your own press thesis , or what would I call that press theses ?
Yes , that'd be plural .
I wanna make sure I do that right . Well done bro . Thank you , I was the editor of my high school paper .
Yeah , you were . You're one of the best writers I've ever met in my life . Yeah , thanks , I'm announcing that I love it .
But so thanks , buddy , for real . So you're making them in-house now .
¶ Prosthetics and Carbon Fiber Manufacturing
So what kinds of equipment do you need to do that ?
So the final product is made of resin and carbon and some other materials .
But how that works is you have a positive model , you lay your materials over it , you have a vacuum pump and actually the one I'm using is from a dental office and so it runs , vacuum , pulls all the materials in , and then you run resin through it for a wet elimination and then , as the resin sets up , then you take that off , you grind it out and shape
it .
You do this yourself .
I do .
Holy cow cool . What are the engineering aspirations you have back there ? You're coming in handy with that .
It is yeah , so I think everybody's always surprised when I tell them that I use power tools every day .
That's cool . That is your husband and I went to that carbon fiber bike manufacturing company . Yeah , that's slick .
I wish it was that streamline , but because everything is so individual and one off , it's very hands-on , very technical .
So what does a typical carbon fiber leg sell for ?
There's a huge variation and it just depends on what the components are . You have a very basic transfer leg for below the amputee , maybe $7,000 .
Holy cow .
Right , and that's what you hear , and you hear about how expensive these things are . But a lot of people don't understand that that is all-inclusive , so we don't get paid for time , we don't get paid for any care after the fact , so it's all about . All of our cost is in the delivered product .
So that's the eval , that's the casting , that's all the adjustments and follow-ups after getting maintenance . So it's a little more than what's presented on paper .
Sure , that makes a lot of sense . It's actually kind of comforts a lot right there . Yeah , they know what it is . It's a yeah Cause I'm sure you have some pre-evaluations , right Consultations then of course . Then you do the fitting and I mean there's a lot of work in that , and then you're adjusting afterwards .
So there's no co-pays for visits or anything like that , oh wow .
That's all . Does the insurance typically pay for these legs ? Yes , Does , okay . So why are most of these ? I mean , is it mainly legs or are there other breast theses that you provide ?
Sure yeah , Upper extremity , lower extremity . We do orthotics too . I don't talk as much about those so bracing . As well Do pediatric and adult .
Wow Like full service .
Yes .
So why would ? Why do most of these amputees need limbs ? What is that driven by diabetes ? Or what is the primary driver accidents ?
I know diabetes is the leading cause in the US . There's , in this area , I see , a lot of accidents as well , and there are a lot of different reasons . There's some congenital reasons that contribute to cancer . Motor vehicle accidents , I see caught a bit , of which I think we'll actually start seeing more of in this area .
Just because of the population growth .
Yes , and the infrastructure around the roads is gonna be a challenge , and we see rats all day , every day , cycling .
Really A lot of people get hurt on bicycles . People don't realize it . Is that true ?
Is Mark right ?
And most of the time those are more neurological injuries they may have .
Head injuries huh Wow .
Lasting effects .
Is that mainly from like road biking , or is it mountain biking too ?
All of them , all of the no .
Now you , I know that's like one of your specialties that you're providing over there , isn't it ? Yes ?
Yeah , and that counts from . How do you promote ?
that it's . What specialty are you talking about ?
Cycling related oh really Injuries .
And prosthetics .
And prosthetics yeah .
Activity specific prosthetics , so getting people back into the activities that they wanna do . That's something that insurance is just starting to recognize as a need as well . 50% of amputees actually die five years after their first amputation .
Wow .
And that's generally from comorbidities right and so they're not good .
What does that word mean ?
It's additional diseases and disorders that they're dealing with , so they're not the most healthy individual to start with . They have an amputation . Now they're in a wheelchair .
And they're immobile , decline , sure , and I'm sure there's a lot of mental factors of that too , right , mm-hmm , indepressed .
Yeah .
So it's close to my heart to get these people up and active again . So , that they can work on their health Cause . For a lot of people it's kind of the wake up call I have to do something different .
Yeah , I just noticed that on your website when I was reading I mean just kind of your which I love the mission , I love mission based these guys really have a real mission .
Yeah , you know , it's not just like trying to get somebody to buy your crutch or something .
Right exactly , or buy a prosthetic right Right .
¶ Bifermaza's Impact on Mental Health
Bifermaza means more about caring and getting them back into a I mean really a positive mental life style in life . Yeah , I mean I could imagine like I mean I could imagine that a lot of these folks are . I mean it's like hitting with a ton of bricks .
And the impact they're like .
I think what their next day looks like yeah , yeah , and now your whole life's changed . You lose you've met and lose some hope , right , and but you guys are really caring for self-esteem . Hell yeah , man .
You can work with this .
These are coming out yeah , yeah self-images just completely rocked . So , that's what I hear a lot of times those questions about like , isn't it really depressing work ? And it's not at all . It's because we're catching people on the other side .
So it's really a lot of fun to kind of guide them through the process and say you're gonna be able to get back to what you wanted to do and what you're doing prior , and so we're really able to kind of give them a little hope .
Yeah , yeah , I was , I'm sorry . No , go ahead , mark .
I just wanted to ask do you see a big difference in like male and female patients about their mental state ? Related to this ?
No , I think they struggle , as there is some gender differences , but I think there's equal struggles on both sides .
I feel like men in particular really worry about their ability to take care of the house , go back to work I mean , provide an income for the family , which I think is true in a lot of scenarios and women worry about keeping up with the family and keeping up with the kids , and a lot of them are working too .
So I mean , it's the same thing , but some of them just cultural dynamics . There's some really deeply ingrained concerns for both sides . And then self-image as well , and I can't tell you how many times I've talked to people about is my husband or is my wife still gonna love me ?
Yeah , oh yeah , I'm sure I believe it .
Yeah , well , that's pretty deep and a big deal , right , I mean it is yeah , you end up being a little bit of a counselor and a marriage counselor while you're doing all this too , but what I like about it , though , is that you're attaching your passion behind that , and I mean I could only imagine going through an event that would create that , but then being
able to find a clinic like yours , that , where you , as the entrepreneur , leader of that business , that you actually really genuinely care about that and that's your mission . I mean being able to get coached to that . I mean that'd be so relieving .
Yeah , I mean I was actually reading on the side about it , and I just put myself in that position for a second , and I actually legitimately had like an emotional relief , in a way that , if something like that happened , that there's somebody out there that can help you .
Yeah , yeah , we end up doing a lot outside of kind of our spectrum of just taking on coordinating care too , Because a lot of times that people go home and they don't realize I'm gonna have to have my house modified and I'd now need to have my car modified . And they're thinking that far ahead .
So just making sure that people are making connections in the right areas , getting referred to the right places .
Yeah , it's like you had this testimony on your site from a guy that said this is my first year involved in this and he was just kind of talking about like I had no idea what to expect Going in on the pre-eval before he had the amputation .
Like he gave him that hope and that understanding that this isn't going to destroy everything like you're expecting it to .
And that's something that we it's a noble endeavor .
Totally is man . I love it .
We believe really strongly in pre-operative counseling Because there's not a lot of resources out there . Typically , you know your surgeon's extremely busy . They're in and out of the room .
Sure right , and the questions ? Yeah , and surgeons are known for bedside manner . Right yeah , Spending time with you .
Yeah , and a lot of them don't know .
They do a procedure .
Too much of the process that happens after that .
Sure , well , they got something to focus on , right , they have a lot of responsibility and just that , oh that box , and I could never do it .
And then honestly I've talked to a lot of them they feel like it's a failure . You know , when they get to that point of they're gonna have to have an amputation .
And so it's a hard discussion for them and they don't .
They don't always want to own it . So we try to kind of take that space and make sure people are taken care of and know where to go , because there have been a lot of people to go home and sit for six months and not know who to call and , like we were talking about earlier , they deconditioned during that time . So we take that really seriously .
We have a support group as well , so we try to get people .
Oh , that's good .
In front of your advocates , so the people that have actually been through this personally .
Right . Because I can tell you from a clinician what's gonna happen , yeah , and then you can walk into the room that's actually missing a limb and that you're not alone .
You're not alone , yeah , and you can do it , I'm sure . So let's go back to the business aspect , though . How did you decide to start your own business ?
Sure , so both of my parents were entrepreneurs . My dad is an attorney , my mom's an accountant . I think back you know the generation before that . My grandpa was a dentist that had his own practice and a family newspaper , and my other grandparents had a western auto and , yeah , I grew up watching everybody work really hard and I was like this doesn't stop
¶ Transitioning to Own Business From Corporate Healthcare
. This is , you know , it's not eight to five . I never want to own my own business , I'm just going to work for somewhere that I , you know , share a mission with and that's what I'm going to do Right . But you know it's when you make demands . They tend to come back in your face Right , and I am a very passionate and outspoken person .
So when things start changing and I don't agree with the way that care is provided , I just seem to continue to hit a roadblock in not being able to provide care the way I wanted to . So I really , just , like that , was forced to make the decision .
And you know , on top of that , not only patient care but the way that people in the business that employees were taken care of as well Was that because your clinics were acquired by private equity , and private equity is just purely financially driven .
Yes , I mean that was a big .
They didn't share the mission necessarily . Yeah , yeah .
I mean the culture went from a family-owned business you know it was very much about the people that were in it to a corporation and it was then became , you know dollar amount and profit margins and we need people in and out of here in 45 minutes .
Turning the tables . Yep .
Yeah , table like a restaurant , exactly Like get them in and get them out . Get them in and get out .
Because again , we don't get paid on time . So the faster you can get somebody in and out and delivered , the more money you make .
So when did you decide you wanted to do your own thing ? And how long was the gestation period ?
Sure , this has probably been three years in the works and I think a lot of it stemmed from burnout and we all went through COVID and there was a huge shift in workplace culture at that point and I was looking at changing degrees and fields and doing something different and getting out of healthcare , which there's been a huge shift of people out of O&P , which
is orthotics and prosthetics , because of the same reasons , and we don't have enough people replacing practitioners now , so there's a huge shortage , there's an increase in amputation rate and then people leaving the field . On top of that , I think like 25% of the graduating classes leave . They don't even stay .
Leave what Rheustetics and orthotics . Wow , they get a degree and they don't even practice what they study .
So I mean I was looking at that and so I was looking at ads for working at Mercedes and I'm like I could do that . I mean it's you know .
Sling cars .
Yeah , I've always wanted to be a car slinger . I've always thought that women should be more selling cars , absolutely , you know , because I think other women would respond to that . Yeah , not so threatening . Yeah , exactly , I mean , it would be refreshing to have an intelligent person .
Yeah , I don't think I've ever seen going to a car lot and not not seeing a bunch of guys up there . Yeah , and you pull up and you're like , okay , which one's going to be the first one ?
Yeah , they're like coming out in the last night and it's just like yeah , I feel like I'm in a gym . Yeah , which ?
is you know , right which one was less munchies man .
That's funny .
Anyway . So I was looking at doing that . I was just trying to figure out . You know I don't want to do this the rest of my life and I've got 30 more years of working minimum .
But what's the ? You don't want to do what like ? What's the this on that ? Because you talked about the burnout and the folks not going into the field . I mean , what is the that part ? The ?
this was the company I'm arguing for the what I felt the correct way to provide care . You know you got . We fight insurance a lot .
As it is that I have to fight insurance and then fight the company and fight the policies and , you know , sell three more legs so we can have a pizza party for lunch was just I couldn't do it , you know it's brutal , man I mean , but it's real .
Yeah , that's what happens . Yeah , I'm decays the purpose behind the business .
Right . I mean , we sat here and talked about purpose and where it comes from , so I just I couldn't , mentally , could not do it .
So three years in the making . So when did you do your business plan or did you do a ?
business . Well , I did very , very many different versions . I was actually started as an adaptive gym , so I wanted to open a facility that was geared around exercise and tailored to people with disability , and that they can go in and use equipment safely , because there's there's a lot of variations there that you know .
Getting on a stationary bike does not look the same , and so I worked with the ? U of A small business and technology department and set up a business plan around that .
What would you deal with over there ?
Mary .
Beth .
Stephanie Parsons and Stephanie really championed it for me , she met with me and we
¶ Starting an Adaptive Training Business
. We did lots of different business plans and then at some point we sat down and she said look , taryn , you're obviously going to go do something .
You need to go do it it was kind of the get off the pot or you know , yeah , you gotta have that talk . Yeah , you do , you do analysis forever , yeah .
And so , yeah , we we ran a lot of numbers on the adaptive gym , and that was probably 2000 , early 2019 . And then COVID hit and I was like maybe a gym is not a good idea , and so it evolved into a little bit of mix of both . So we , you know , right now we're doing prosthetics and orthotics , but also have adaptive training on the side .
And so you know , doing the sport , specific prosthetics , and then offering personalized exercise plans that are adaptive , taking into those considerations .
So you kind of have a micro market then . I mean , you're really focused on folks that have a need for this , but they want to be active .
Yes .
And and yeah probably don't all want to be active , right , right .
So like I mean you're not , I mean like that's interesting to me because folks that have had active lives , that want to have active lives afterwards finding you is like I mean it's fantastic .
Right , because , again , most clinics are focused on getting you in and out .
Yeah , wow .
And so you know , it's like you know , it's like you know , you're not just talking about the parts , regardless of what that looks like , not necessarily taking the extra time .
What's your , what's your tagline in your business , to kind of identify ?
with that market , like , have you , do you have something that , um , you know ? I think the closest I've come has been the uniquely designed crafting for your goals .
I'm just thinking like prosthetics for performance . He's a marketer . Yeah , he's a performance prosthetics .
Yeah , you should listen to him .
He's , he's good , but . But I mean because , like , because I think that if you have an audience out there right , because they're going to have that need and you're getting that need , but that's a differentiator . Yeah , it totally is .
And but that attachment to that tagline could make , because people need to be able to , like immediately understand what your business mission is and if they can attach to that , then they're just going to give a call and then they're going to know they're going to go in there with that expectation and you guys are going to solve it .
Yeah , that's good advice , it's really good advice .
Yeah , you're welcome . So , terry , where did you get the money to start this business ? I assume it takes a significant amount of money . You've got to have the right kind of facility and then all the equipment you need to be able to make the prosthetic prostheses . Excuse me , that's great . I would say prosthetic devices , I guess .
And a lot of it was .
So how did you finance that ? Yeah ?
A lot of it was just good fortune and timing and we moved over here Again . We had two houses between Mountain Home and Rogers and we sold those kind of as the market was booming and made some money on that , consolidated into one house and again hit that and sold it at a really good time . So we downsized to a house that was a quarter of the size .
We pulled a lot of bills and made a lot of decisions to say we're not going to be tied to this lifestyle , this house . We want to do something different .
That's entrepreneurship ? Right , there , isn't it ? Sure is , you did it , we did it , we've all done it .
Second mortgage .
Yeah , and your husband's supporting you the whole way through .
Yes , tell us a little bit about him . What's his background ?
Sure . So we are both prosthetist , orthetist , which makes for interesting dinner table conversations .
lots of legs and I just keep wanting to make a joke it's so bad about I'd give an arm and a leg to be in that business . But I'm not . But you just did it . I know I'm sorry . You found no way to do it . I'm a dad . I make dad jokes . Yeah , that's probably . I'm sure I'm sorry , but anyway .
So he comes from a similar background , then , in terms of the kind of work that he's done .
Yeah , and actually he was my residency director , so there's a little bit of complicated history there .
But he is extremely skilled in what he does and I learned a lot from him and I was very fortunate to kind of come through a time we had a lot of really good teachers , which is , I think , part of my success and the patients that have followed me is because I am very good at what I do , because of the experience up in the past .
So , again , he's a practitioner as well and he was the COO and then CEO of the company that we worked for . So a lot of experience on both sides of practice and business management .
So he's got his own business at this point right .
Yes , so he's doing some consulting work . He has got a year left on and on compete
¶ Transitioning to Self-Employment and Small Business
that was . Another big decision for us was , as we're downsizing and thinking about you know , about doing something different , because it was eating us alive to support a mission that we didn't believe in . So we made the decision of doing them .
He's a little older than me , so in 40s do I have this huge career change and step back and take some time to reassess what we do , or do I stay in this kind of comfort bubble of what I know and a steady paycheck ? So we both quit relatively at the same time and did something different , which was a huge leap .
Yeah for sure . But so what is your experience of self-employment versus working for the big corporation ? What's good about it and what's not so good about it ?
You know I mean the work hours never end . Obviously I mean any entrepreneur will tell you that .
But I can say Well you do get to sleep like six hours a night . I mean , come on .
And then we wake up at two thinking about everything you did today .
Yeah , but .
And so but that was the thing to me was I have the same work ethic and really the same drive , regardless of whether I'm working for somebody or for myself . So a lot of what I'm doing I was doing anyways . I have a lot of ideas , so I was coming up with ideas and changing the way that we did things , regardless of where I worked .
So it's been . It's a little easier to make those changes , though , in your own business , isn't it ?
I've had the control to do that . It's been a game changer . I was telling Kyle last night too that I was as tired as I am and as many hours as I'm working , I'm not burned out .
Yeah .
You know I'm working harder than I was , but because I'm passionate about what I'm doing and I feel like it's right , you know , building self-employed . It's not burning me out like I used to Plus .
I'll also always call it the escape factor , right , because you have the freedom to bounce . Yeah , I think , mentally , knowing that you can make that decision is a huge , huge deal , you know , whereas if you're employed , you're , I feel like you're trapped , at least that's how I feel .
I think a lot of business owners feel trapped too . Yeah , Because they've got commitments . Yeah , right , Like this is my bad Leases and there's nobody to turn your notice into . True , you know , but I hear what you're saying , so would you ? I'm just curious because I know .
I remember when I left corporate America and went into my first quote real business I was surprised by how much time I had to work on my business because of all the other stuff that sort of comes along with working in corporate America , like pointless meetings and providing information to other people that didn't benefit you and you just caught all that I got out
of it .
Recaps , and four calves Exactly . It's like expense report .
You just caught all that out and then suddenly it's like holy cow , I can actually do what I'm supposed to do .
I was surprised at .
Was did you find ?
Partly that , but also you know there were a lot of things that you're told and I think to kind of keep you from really considering opening your own practice . I mean you hear about how hard it is and you don't want to take this risk and yeah , I mean it's all these things and how expensive it is and there's no money in this .
And yeah , you get on the outside and it's like you know , really , if you keep it lean and you make smart decisions , this is not that hard . And you ask for help in the areas that you don't know how to do .
There you go . That's big , that's a big point , that is a really big point . So there's a lot of those areas , well , but I think that I mean like that's a huge statement , like you're not an accountant , don't be the accountant For us , you're an attorney , whatever , and some people just want to try to do everything themselves .
Because you think I can't afford not to . You can't afford to do it yourself , and you can't afford to make mistakes , so how many people do you have working for you ? Right now I have five , okay .
Bringing on a sixth here in the next couple of weeks .
And so like are these people ? What do they do ? Are they all practitioners ?
So I have .
Any support people .
Sure , I have someone that is doing billing and insurance and she is actually kind of a dual role . She has a certificate in Fitter and Pedorthus , so she's able to do certain level of bracing .
I see .
And then I have an assistant who is able to do most of the treatment care and it's just not developing the treatment plan , so she's fairly independent .
And then I have an admin and a peer advocate as well , so somebody answering the phones , making sure people are taken care of on the schedule , requesting all the documentation from the doctors , and my peer advocate does some of that for this area , but also just visiting with patients during the hospital visits , and it was kind of when you open the business .
How many folks did you have at that time of opening Two ? And so you just kind of slowly add on . Slow that on overhead then yeah she's doing it .
Yeah , yeah , yeah yeah .
But that's been something that I've seen that has been really flattering and very cool to see is the people that have approached me , because we have focused on culture and building something and I think our passion and our mission is so visible that the really just the cream of the crop has approached me .
I really believe in that Totally . You know you've got a real mission and you make sure you live that . That's right . People respond to that . The workers respond to that because they want it Absolutely . So now , what are your plans at this point ? Where do you go from here ?
I mean , there's obviously a limit as to how many people need the services and products that your business provides , but this is I think everybody asked me that because they're like well , how big are we looking at ?
going and you know what's your ?
vision and I don't want to be a big conglomerate . Yeah , I plan on growing to three or four clinics and really stopping there . Yeah , I don't want this to be so big that it's I can't control it and I really want it to be a small family business . That would mean taking care of 10 , 15 employees and just keeping things lean and in the business .
I have an idea what's that , because I can understand what you're saying is you get bigger , you open up more offices , you have more overhead and then it starts turning into what's hard out of yeah , exactly , well , I'll create that .
I think to a certain extent , for sure .
But I think the cool thing is is in today's time there's a hybrid approach that can allow you to actually extend your mission digitally in a way of how you help folks right .
You can scale the pre-consult , you can scale the post-consult , you can really help Develop videos , education yeah , man , absolutely and be able to monetize those courses and those classes , those peer groups . I mean kind of consider that .
And then you have your clinic , such as your foundation , but then you can go worldwide with your mission to community help people .
He's got you going worldwide . See Worldwide .
You can see how Eric thinks yeah , yeah , but I mean you can scale that out , that's on your prediction , I mean . I mean I just keep going back because I mean people need like this stuff .
Obviously You're championing a market that is actually really really big , but to your point , I mean like you're scaling that to go worldwide with physical locations is a massive , indeed massive , undertaking , right , yeah , and keeping that culture that you've started , right , because I mean just an idea for you .
How do you Eric's got some good thought process . How do you deal with the personal life and kids ? How many kids do you guys have Three , Okay and how old are they ?
10 , eight and three .
Wow , Okay . So how do you manage all that with having this business ?
That was kind of a side blessing of Kyle stepping out of his position and , honestly , a little bit of the non-compete ended up being a blessing as well , because he's really stepped up at home and done a lot of the pickup and drop off from school and the school activities and cooking dinner .
I think he's cooked dinner more times since I quit in the last four years .
Is he a decent cook ?
He is .
That's good . That's a surprise . He's a competent guy . He can do a lot of different things . He is so meticulous yeah .
He's doing everything that he does . But he'll follow the recipe to the tee and I'm like , well , let's see if we can have this , we'll replace it with that kind of thing . But I mean , I think that's been an interesting dynamic shift because he is very driven .
You know , he climbed the ladder , he really had a set path and we meet as a family and say this is how we make this happen and this is what your new role looks like , and just taking it with strides and supportive as can be .
That's awesome , so real quick Leck .
Whenever you're consulting with your clients , is there any kind of innovation that when you go back like I'm just kind of picturing like in your customizing for that certain person's lifestyle , have you ran into like any innovative solutions that you're like that just aren't on the market but you like customize this and you really like I can imagine that and what's
new ?
Yeah , what you're pushing forward yeah .
There are a lot of innovations and kind of the socket technology , so the interface , because if you think about , you know you can have the best knee and the foot that's out there , but if you have discomfort in your socket , if it hurts every time you take a step , it's not gonna do you any good .
So a lot of the innovation out there is focused around socket fit . So there's some different ways to , you know , hold these things on different suspensions and volume management , Cause that's the other big challenge in prosthetics is you have a static shape that your limb goes in and it doesn't change with you .
So if you , you know , have more water one day than the next and you , you know , fluctuate or you lose 10 pounds , these things don't fit anymore and then they're again very expensive , right ? So we're trying to make them fit and last as long as possible .
So there's been some changes and innovations on how to change the socket and keep it a little more dynamic , and that's been where I've had the most interest in focusing .
So you're like always looking for new suppliers and new innovations that are out there in the world . You're researching that and then test those things out and just kind of keep modifying .
And there's a lot more technology out there than what we're able to use because it's limited by insurance coverage right , robotic arms and things .
What about that ?
There's sensors that you can . That'll actually transmit sensations . So you can have like pressure yes , yes , Recently I'm just stumbled across videos or news items on that , and it's a long ways from being you know , available , widely available because of insurance .
So the insurance kind of blocks innovation .
For sure .
What about , like Medicare , medicaid I mean , do you participate in any with that ?
Yes , yeah , and that's the majority of our patients , because they're on disability right .
Gotcha .
So there is a good chunk of private insurance , but a lot of what we do is Medicare and Medicaid . Medicare actually has pretty good coverage . You can get most of the technology out there .
Medicaid is fairly limiting but , you know , we try to find ways to get people what they need , whether it's vocational rehab and different grants , and that's , I think , something that we do well is try to find people and resources on getting what they
¶ Private Insurance, Future Plans, Business Starting
need .
So are you saying that the private insurance is blocking more than ?
Depends on the insurance . Some of them are really good and some of them are not . Yeah , I've had conversations with case management of you know . They're telling me why does this person need a leg ? Have you tried to hop to the bathroom recently ? Now do it for the rest of your life .
Yeah , right , you're kidding Right . Wow , that's crazy yeah .
So we always call it fighting the good fight and really have to go to head with insurance .
Are there any good innovative insurance companies that have foresight and that can , like that , are trying to just bring that wheel along for innovation , I feel like Blue Cross in Arkansas , has been one of the better ones . Really , that's good to know and maybe T is listening out there .
Don't get UnitedHealthcare .
That's what I think I have . I mean U of A it's UMR , Is that ?
UMR is all right .
Okay , you all provide my insurance .
Our listeners are going to appreciate that advice ?
What about people who just don't have any insurance coverage ? Is there financing available to them ?
So we definitely do , Cash price greatly reduced . At that point it becomes like a percentage over our cost and you're just doing the work for free .
You're just trying to help the patient , you're not making anything on it .
And a lot of times , depending on their situation , they can qualify and we help them through the process for aid but again . There's voc , rehab and some different resources out there . There's a few grants and some nonprofits like Steps of Faith , and I think Wiggle my Toes is another one .
Wow .
So you know it kind of staying in the know of what's out there can really help a lot of people .
Are those local organizations ? No , that's right . The Brooklyn National .
Cool . Well , what else is in your future ? Let's say , we build this up to four clinics and you're got it where you want it . Then what happens ?
Yeah , something I'd want to expand into would be destination care . So you know , we actually live over by Kohler and when we go on walks I see people come and it's amazing how many amputees I've ran into .
So you know , maybe people come in and we fit them with the bike specific prostheses , they go ride at Kohler , test this thing out and get them and send them back to their real world and that's , I think , a different model of care . Put them up at a vacation housing , yeah .
That would be really interesting . So you're telling me like people come from out there and they stay at a certain place and get this Because you have a design that plays to fit their needs . That's cool .
Yeah , wouldn't that be fun .
Yeah , that would be very cool .
With having the different clinics . I could do mountain biking here , I could do fly fishing and mountain home , because that's a big fly fishing .
Sure .
He could do hiking , prosthetics or kayaking or whatever , but it may be a whole outdoor adventure .
Eric's got an outdoor adventure company .
Well , I mean , it's not really ramping up right now . Okay , well , you've only got about 10 things you're trying to do . But I mean , like this , is it actually Get out ? Get out , yeah , but it's a little bit of ways from actualizing . There's a lot of risk in that .
I wonder , though , if there'd be a way to integrate that with what Terence did Totally . Yeah , like you could have a special event and you could handle a part of that . Yeah , yeah , yeah , yeah , you should talk about that . Yeah , we should . Yeah , because I know that's on your agenda for a few weeks .
Yeah , I know what to do that , along with building that castle on the hill that you're building over there with the driveway that's in the wrong place . I'm just trying to get a driveway done .
Yeah , you know the castle will come later , but the big thing is this studio right .
You can expand that . That's coming up next week .
So next time you come in , you know we'll be in a little bit more of a upgraded studio .
Oh it's going to be fantastic . I'm really excited , yeah . So back though . You guys also own some commercial real estate , don't you ? Yes , but your business is not located in your own building . Why is that ?
No , in part it was . I wanted to serve the Bentonville Bella Vista area .
I see , so you went north of your uh-huh .
One , there's not a provider in this area , so a lot of people are having to travel , and if you think about people with amputations , they really don't want to drive through an hour of traffic and most of them are having to coordinate somebody else driving them as well . So it's somewhat convenience of care .
Two , it puts me again closer to some of the outdoor activities that I want to tie into in the future .
Yeah , so your location is kind of tied a little bit . I mean there's trails galore , right Got it .
That's cool yeah . That's really cool . Well , it sounds exciting and you're doing a great job , obviously to be where you are now . When did you start this business ?
I signed a lease in July , so we are- .
Of 2023 ?
Yeah , wow , this is the new thing . You know what ? You've only got five people over there , dude , that's impressive , yeah .
It's been a little bit chaotic , but it's been good it's fun little roller coaster ride .
Build all that out . What advice do you have for people who are thinking about starting their own business ? Maybe they're like you , where they have some kind of a particular professional skill . What do you say to them ? What advice would you have ?
That it's definitely a scary move , but well worth it , and just take the plunge . Assess your finances so that you aren't stressed about paying the rent , but just go for it .
That's cool . Yeah , I'm with you . You got to do it . Yep , I could make a crude statement , but I'll refrain .
And I would add on to what you're doing , like the purpose , mission driven rate , reason behind the business is so critical , and that's something that I just don't think is missing . You can't put that in a spreadsheet because you're going to have to power through a lot of risky decisions , but to believe it in your mission and your purpose will get you across .
It gets you through . Yeah , and the bad times we all hit .
Yeah , believing in something . Yeah , I'm like freaking brave heart .
I mean , it's a tough balance of listening to feedback and getting all the feedback . Somebody's going to tell you this is a bad idea . And you have to know that and listen , but also believe in what you're doing and pursue .
Yeah , and they try to sway you away from your , your outright demographic that you've been going after , and they don't , may not even understand that They'll be like well , what you really need to do is turn the tables Like . You need to like . You need to have 40 pages .
Pivot , pivot , the big word of the day . That's right , you've got to pivot . So would you say that things pretty well worked out according to your plan , or were there any major departures ?
No , I think you know it's . It's been going pretty smooth . I don't feel like I've had to give up or change your pivot anywhere too majorly .
See , I love hearing that because , yeah , a lot of people say , well , the business plan doesn't mean anything , you're going to throw it all the way the day you start your business . I never did that . Yeah , I felt like the business basic business plan still viable 35 years later .
The timeframe you know , I think it has been changed quite a bit . It was accelerated and you know , and like we talked about , I've brought on five people and it's like I guess I will pay myself next month . You know , you kind of just keep kicking the kid down the road of how long can I not collect a paycheck ?
We've all been there .
baby , we can bring on the next member , because it's more important to have the right team and bring this person on .
It's an investment mode and for you to stay focused on which your strength is , or get to where you're trying to get to right , it's better to postpone getting financial reward to get focused Too many businesses , I think the owners try to extract too much too early and they basically kill the business .
They're sucking all the working capital out of it . How do you market this business ?
We grow a lot by word of mouth . Some of it's referral based too , and that is from doctors . Yeah , surgeons some primary care as well , but it's it and it varies so much based on area the small towns that we're in is very much . You can get in front of the physicians .
They're down to earth , you have a conversation with them , what you're trying to do and why . I will say Northwest Arkansas has been very much more political than anywhere else and it's really hard to get in front of surgeons and say , hey , we , we offer something better and getting them to listen and why they should send them to you .
So Northwest Arkansas has been a lot more word of mouth than I think you know , just proving to people that we can do a better job . So , most of my patients up here have been people that honestly , that some of them haven't walked comfortably in six years . And they come and they find me and I'm like let's give it one more try , Let me try .
And it takes a little bit of risk and hope for them to say , maybe I can hope that this doesn't hurt to walk and yeah , but when you get them up and going and they're comfortable , they won't never leave you .
Yep Makes sense . Well , we really appreciate your being here with us today . Yeah , absolutely Awesome , awesome business .
Yeah , yeah .
All right . Well , this has been another episode of big talk about small business . Check out our website at wwwbigtalkaboutsmallbusinesscom . We're on all the major streaming platforms YouTube , spread the word sign up . We have a subscribe option on our site . Don't forget to ask questions . We love your questions .
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